Did this teen pregnancy prevention program have the opposite effect?

By Mary Brophy Marcus

August 25, 2016 / 4:58 PM
/ CBS News

Teen girls who took part in a popular type of pregnancy prevention program
were actually more – not less – likely to become pregnant compared to girls who didn’t
participate, a new study by Australian researchers shows.

The study evaluated the effectiveness of a
pregnancy prevention program adapted from a U.S. program called “Baby Think It Over,” created by the company Realityworks, which involves caring for a realistic baby doll that simulates some of the demands of a newborn. Similar programs are used in 89 other countries, the authors
said.

About 2,800 girls – ages 13 to 15 – from 57 schools in
Western Australia were randomly assigned to either a six-day pregnancy prevention
program taught by nurses or to a standard health education curriculum.

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The six-day program included a baby simulator – a doll the
girls took home over a weekend that cries when it needs to be fed, burped,
rocked or changed. It measured and reported mishandling, crying time and
the number of changes and general care the fake baby received.

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The nurse teachers also offered an educational component – they discussed with the teens the
dangers of smoking, drinking and taking drugs during pregnancy and they taught the
girls about the importance of nutrition for a healthy nine months. Sexual
health, contraception and the meaning of a respectful relationship were
discussed as well as the financial costs of having a child. The students also watched
a video documentary featuring teen moms talking about their personal
experiences.

All of the participants were followed for about seven years, up until
age 20, during which time the researchers compared data from hospital records
and abortion clinics to track how many pregnancies and abortions occurred among
the young women.

By the study’s end, 17 percent of the teen girls in the baby simulator program became pregnant, compared to 11 percent in the control group.

“Our study shows that the pregnancy prevention program
delivered in Western Australia, which involves an infant simulator, does
not reduce the risk of pregnancy in teenage girls. In fact, the risk
of pregnancy is actually increased compared to girls who didn’t take part
in the intervention” the lead study author Dr. Sally Brinkman, from the University of Western Australia in Adelaide, said in a
press statement.

The authors noted that the overall participation was low in
the schools, where pregnancy prevention programs are voluntary. They also said that the girls in the control group were economically better off than the
girls in the “baby” group, but when they compensated for that, the results didn’t change.

Birth rates among teens​ in the
U.S. have dropped dramatically since 2006, according to a report out in April
from the U.S. Centers for Disease Control and Prevention. The teen birth rate in the U.S. is down about 40 percent from a decade ago. Many experts attribute that to an increase in the use of birth control, particularly long-acting reversible contraceptives like implants or an IUD.

Dr. Cora Collette Breuner, with the division of Adolescent
Medicine and the Orthopedics and Sports Medicine Department at Seattle
Children’s Hospital, told CBS News that the study is impressive in size but it leaves questions, such as what type of feedback did the girls get when they completed
the prevention course?

“Were the teens graded on this? What is the definition of
success in this program? That if you hate it and you don’t want a kid at the
end, if the baby cried all the time and pooped and it died of SIDs, would
that be an A? Or is it ‘yay, you did really well and the baby’s still alive and you get an A because you’re going to be a great mom’?” she said, adding that didn’t mean to sound morbid.

Breuner – who chairs the committee on adolescence
for the American Academy of Pediatrics, and who authored the academy’s most recent policy on sex education – said the right question might be, “Should we put this way of
trying to prevent teen pregnancy to rest?”

She also noted another missing piece of the puzzle: the girls in the study could
have had a lot of experiences after the pregnancy prevention program was over that
influenced their choices, and those didn’t appear to be taken into account, she said.

“So many things could have happened to these girls in the five to seven years from when this intervention was. They could have gone to school or
not. They could have moved. Their parents could have gotten divorced. They could
have started abusing drugs,” she said, adding that it would be interesting to know how many of the girls actually went to college​.

“It’s an incidental finding. Is it truly causal? I don’t
think you can demonstrate that unless you get more on events that happened in
that time,” Breuner said.

“Simulated motherhood may create actual babies​ and
motherhood. This is not an effective intervention, but a more comprehensive
program is,” Breuner added. “Personally, I think if you educate a girl and get
her to college, they’re not going to get pregnant. Get them thinking about
something else, not taking care of a simulated baby.”